Surgical Outcome Risk Tool (SORT)

The Surgical Outcome Risk Tool (SORT)

The SORT is a surgical preoperative risk prediction tool. It provides a percentage of death within 30 days of inpatient surgery for adults (exclusions in the first version of SORT obstetrics, neurosurgery, cardiac and transplant surgery). It has an advantage over many existing prediction tools by consisting of solely preoperative variables and allowing rapid and easy data entry. In the analyses in the first SORT paper, it was also found to have greater accuracy than two other preoperative tools.

The SORT app is now available to download for FREE from the App store (Apple).

The spreadsheets used for SORT and SORT2 calculators and AXA-PPP surgical procedures and severity are available here

The SORT was a collaborative effort by researchers from NCEPOD and the UCL/UCLH Surgical Outcomes Research Centre (SOuRCe).

The SORT was derived from data collected during the “Knowing the Risk” NCEPOD study comprising data from over 19,000 patients from 326 hospitals in the UK. The SORT app is now available to download for FREE from the App store (Apple).

The results of a survey of over 500 participants in the UK in May 2015 indicated that the SORT web tool was mostly starting to be used in preoperative assessment clinics, high risk clinics, and the emergency and surgery departments.

A second version of the SORT was published in 2020. Data were collected from patients from the UK, Australia and New Zealand. This risk calculator contains the new feature of clinician’s estimate of risk – recommended to be assessed by senior decision-makers in the multi-disciplinary perioperative care team http://www.sortsurgery.com/

Click on the app badge for direct access:
App Store (Operating system: iOS 9.1 or later required; Hardware: optimised for iPhone 5 or later. iPhone version works on iPad and iPhone touch). When downloading the app using an iPad, please select the ‘iPhone only’ option at the top left hand side of your tablet (Please click here for installation image).

1. Original version of SORT – click here
Protopapa KL, Simpson JC, Smith NCE, Moonesinghe SR. Development and validation of the Surgical Outcome Risk Tool (SORT). Br J Surg 2014. 101: 1774-1783.
The SORT was a collaborative effort by researchers from NCEPOD and the UCL/UCLH Surgical Outcomes Research Centre (SOuRCe). https://academic.oup.com/bjs/article/101/13/1774/6137960

2. SORT editorial by Karen Protopapa – click here
Protopapa K. Is there a place for the Surgical Outcome Risk Tool app in routine clinical practice? Br J Hosp Med 2016. 77(11): 612–613.
This document is the Accepted Manuscript version of a Published Work that appeared in final form in the British Journal of Hospital Medicine, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see http://www.magonlinelibrary.com/doi/10.12968/hmed.2016.77.11.612

3. Clinician’s subjective estimate of risk added to SORT
Wong DJN, Harris S, Sahni A, Bedford JR, Cortes L, Shawyer R, et al. Developing and validating subjective and objective risk assessment measures for predicting mortality after major surgery: An international prospective cohort study. PLoS 2020, 17(10): e1003253. https://doi.org/10.1371/journal.pmed.1003253

4. SORT 10-year anniversary editorial
Protopapa K, Simpson J, Moonesinghe SR. The Surgical Outcome Risk Tool: Where Are We 10 Years on? Br J Hosp Med 2025;86: 1–6. https://doi.org/10.12968/hmed.2025.0228

5. Web-based tool for users who prefer desktop use: www.sortsurgery.com